NPIMap

Organization Active NPI

Jennifer L Chilek MD PA

Doing business as Stone Creek Family Medicine

  • Family Medicine Physician
  • Montgomery, TX
National Provider Identifier
1659560852
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L8307 Issued in TX
Legal business name
JENNIFER L CHILEK MD PA
Doing business as
Stone Creek Family Medicine
Practice address
19782 Highway 105 W
Sui 111
Montgomery, TX 77356-3103
Phone
(936) 582-0220
Fax
(936) 582-0222
NPI assigned
Oct 24, 2007
Last updated
Oct 24, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jennifer L Chilek, MDNPI 1609817436
Title
Owner
Phone
(936) 582-0220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X L8307 TX Primary

Addresses

Primary practice location

19782 Highway 105 W
Sui 111
Montgomery, TX 77356-3103

Mailing address

19782 Highway 105 W
Sui 111
Montgomery, TX 77356-3103
Phone (936) 582-0220

Other names 1

  • Stone Creek Family Medicine Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1659560852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19782 HIGHWAY 105 W",
            "address_2": "SUI 111",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773563103",
            "telephone_number": "936-582-0220",
            "fax_number": "936-582-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19782 HIGHWAY 105 W",
            "address_2": "SUI 111",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773563103",
            "telephone_number": "936-582-0220",
            "fax_number": "936-582-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER L CHILEK MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "CHILEK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-582-0220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L8307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stone Creek Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.